Urine sodium to urine creatinine ratio as a marker of total body sodium in infants with intestinal failure

2022 ◽  
Author(s):  
Seungwon Choi ◽  
Linda Casey ◽  
Susan Albersheim ◽  
Rhonda Van Oerle ◽  
Michael A. Irvine ◽  
...  
Keyword(s):  
Intestinal Failure ◽  
Creatinine Ratio ◽  
Urine Sodium ◽  
Urine Creatinine ◽  
Body Sodium ◽  
Total Body

Approach to the patient with hypernatraemia

2018 ◽  
Author(s):  
Robert Zietse ◽  
Ewout Hoorn
Keyword(s):  
Water Balance ◽  
Arginine Vasopressin ◽  
Critically Ill Patients ◽  
Urine Osmolality ◽  
The Elderly ◽  
Brain Cells ◽  
Urine Sodium ◽  
Water Shift ◽  
Body Sodium ◽  
Total Body

Hypernatraemia is much less common than hyponatraemia, and its prevalence is higher in certain populations, including children, the elderly, and critically ill patients. A common feature is that patients affected have been unable to drink water to correct the disorder. Hyponatraemia and hypernatraemia are both primarily disorders of water balance. Hypernatraemia is caused by a relative deficit of total body water in comparison to total body sodium. Both disorders are often associated with disturbances in the hormone governing water balance, arginine vasopressin (antidiuretic hormone). Hypernatraemia may be due to an inability to secrete vasopressin or a resistance to its actions in the kidney. The diagnostic approach relies on the assessment of the time of development, symptoms, and volume status, along with laboratory parameters such as urine sodium and urine osmolality. If hypernatraemia develop acutely, treatment should be directed towards counteracting the water shift to or from brain cells. In more chronic cases, treatment should be directed to the underlying cause while avoiding overcorrection.

scholarly journals The Effects of a Low Sodium Meal Plan on Blood Pressure in Older Adults: The SOTRUE Randomized Feasibility Trial

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 964
Author(s):  
Stephen P. Juraschek ◽  
Courtney L. Millar ◽  
Abby Foley ◽  
Misha Shtivelman ◽  
Alegria Cohen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Feasibility Trial ◽  
Creatinine Ratio ◽  
Urine Sodium ◽  
Double Blind ◽  
Sodium Diet ◽  
Low Sodium ◽  
Federal Department ◽  
Meal Plan

Reduced sodium meal plans are recommended by the Centers of Disease Control to lower blood pressure in older adults; however, this strategy has not been tested in a clinical trial. The Satter House Trial of Reduced Sodium Meals (SOTRUE) was an individual-level, double-blind, randomized controlled pilot study of adults living in a congregate living facility subsidized by the Federal Department of Housing and Urban Development (HUD). Adults over age 60 years ate 3 isocaloric meals with two snacks daily for 14 days. The meal plans differed in sodium density (<0.95 vs. >2 mg/kcal), but were equivalent in potassium and macronutrients. Seated systolic BP (SBP) was the primary outcome, while urine sodium-creatinine ratio was used to measure compliance. Twenty participants were randomized (95% women; 95% white; mean age 78 ± 8 years), beginning in 7 October 2019. Retention was 100% with the last participant ending 4 November 2019. Mean baseline SBP changed from 121 to 116 mmHg with the typical sodium diet (−5 mmHg; 95% CI: −18, 8) and from 123 to 112 mmHg with the low sodium diet (−11 mmHg; 95% CI: −15.2, −7.7). Compared to the typical sodium meal plan, the low sodium meal plan lowered SBP by 4.8 mmHg (95% CI: −14.4, 4.9; p = 0.31) and urine sodium-creatinine ratio by 36% (−36.0; 95% CI: −60.3, 3.4; p = 0.07), both non-significant. SOTRUE demonstrates the feasibility of sodium reduction in federally mandated meal plans. A longer and larger study is needed to establish the efficacy and safety of low sodium meals in older adults.

scholarly journals Relationships Among Intravascular Volume, Total Body Sodium, Arterial Pressure, and Vasomotor Tone

1961 ◽  
Vol 9 (6) ◽  
pp. 1233-1239 ◽  
Author(s):  
HIDEO TAKAGI ◽  
HARRIET P. DUSTAN ◽  
IRVINE H. PAGE
Keyword(s):  
Arterial Pressure ◽  
Intravascular Volume ◽  
Vasomotor Tone ◽  
Body Sodium ◽  
Total Body

scholarly journals Advances in understanding the role of cardiac glycosides in control of sodium transport in renal tubules

2014 ◽  
Vol 222 (1) ◽  
pp. R11-R24 ◽  
Author(s):  
Syed Jalal Khundmiri
Keyword(s):  
Heart Failure ◽  
Intracellular Signaling ◽  
Cardiac Contractility ◽  
Myocardial Cell ◽  
Renal Tubules ◽  
Intracellular Signaling Pathway ◽  
Body Sodium ◽  
Membrane Bound ◽  
Total Body

Cardiotonic steroids have been used for the past 200 years in the treatment of congestive heart failure. As specific inhibitors of membrane-bound Na+/K+ATPase, they enhance cardiac contractility through increasing myocardial cell calcium concentration in response to the resulting increase in intracellular Na concentration. The half-minimal concentrations of cardiotonic steroids required to inhibit Na+/K+ATPase range from nanomolar to micromolar concentrations. In contrast, the circulating levels of cardiotonic steroids under physiological conditions are in the low picomolar concentration range in healthy subjects, increasing to high picomolar levels under pathophysiological conditions including chronic kidney disease and heart failure. Little is known about the physiological function of low picomolar concentrations of cardiotonic steroids. Recent studies have indicated that physiological concentrations of cardiotonic steroids acutely stimulate the activity of Na+/K+ATPase and activate an intracellular signaling pathway that regulates a variety of intracellular functions including cell growth and hypertrophy. The effects of circulating cardiotonic steroids on renal salt handling and total body sodium homeostasis are unknown. This review will focus on the role of low picomolar concentrations of cardiotonic steroids in renal Na+/K+ATPase activity, cell signaling, and blood pressure regulation.

scholarly journals THE USE OF HYDROXYETHYL STARCH 200/0,5 AS PLASMA SUBTITUTES IS SAFE IN HYPOVOLEMIC PATIENTS AS INDICATED IN CHANGES OF N-ACETYL--GLUCOSAMINIDASE AND CREATININ SERUM PARAMETERS

2016 ◽  
Vol 51 (4) ◽  
pp. 228
Author(s):  
Dewi Wara Shinta ◽  
Junaidi Khotib ◽  
Eddy Rahardjo ◽  
Mahardian Rahmadi ◽  
Budi Suprapti
Keyword(s):  
Hydroxyethyl Starch ◽  
Elective Surgery ◽  
Prior History ◽  
Creatinine Ratio ◽  
Urine Creatinine ◽  
Tissue Edema ◽  
History Of ◽  
The Mean ◽  
Baseline Characteristics ◽  
Two Parameters

Hydroxyethyl Starch (HES) is a compound that improves intravascular volume effectively and rapidly without causing tissue edema. However, HES also has renal safety profile which is still being debated. Based on clinical experience in Dr. Soetomo Hospital, the frequency of acute renal failure following HES 200/0.5 administration at a dose of less than 20 ml/kg (maximum dose) is very rare. The purpose of this study was to evaluate the effect of HES 200/0.5 at a dose of less than 20 ml/kg in patients undergoing surgery. N-acetyl-b-D-Glucosaminidase (NAG) per urine creatinine ratio and creatinine serum were used as main parameter to assess renal injury. This research was observational and prospective design in patients undergoing elective surgery at Gedung Bedah Pusat Terpadu, Dr. Soetomo Hospital, who requiring resuscitation therapy with HES 200/0.5 and met the inclusion and exclusion criteria. NAG was measured prior to surgery and 12 hours after administration of fluid therapy, while creatinine serum was observed before surgery and 48 hours after resuscitation. This study was conducted for three months, and obtained 50 subjects divided into 2 groups, crystalloid group and HES 200/0.5 group. Demographic and baseline characteristics did not differ between groups, except the total bleeding volume. Total bleeding in HES 200/0.5group was higher than crystalloid group (p <0.0001). The mean volume of fluid received in HES 200/0.5 group was 2042.0 ± 673.9 mL, higher when compared with that of crystalloid group (910.0 ± 592.0 ml). Doses of HES 200/0.5 received was 8.31 ± 4.86 ml/kg. Measurement of the of NAG/creatinine ratio and creatinine serum showed significant increase in both groups, but still within the normal range. In addition, the value of these two parameters did not differ between groups. In conclusion, HES 200/0.5 in a dose of less than 20 ml/kg is safe to use in patients who suffered from hypovolemic hemorrhage, without prior history of renal impairment.

Free Amino Acid and Haemolymph Concentration Changes in Sphaeroma Rugicauda (Isopoda) During Adaptation to a Dilute Salinity

1969 ◽  
Vol 50 (2) ◽  
pp. 319-326
Author(s):  
R. R. HARRIS
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Free Amino Acid ◽  
Free Amino Acids ◽  
Free Amino ◽  
Sea Water ◽  
Protein Nitrogen ◽  
Body Sodium ◽  
Concentration Changes ◽  
Total Body

1. Non-protein and protein nitrogen fractions of the isopod Sphaeroma rugicauda were measured in animals adapted to 100 and 2% sea water. 2. The non-protein nitrogen component was reduced in animals acclimatized to the lower salinity. 3. Free amino acids accounted for 88 and 74% respectively of the non-protein nitrogen in the two salinities. 4. In 2% sea water taurine, proline, glycine, alanine and glutamic acid showed the greatest decreases in concentration compared to the levels measured in animals adapted to 100% sea water. 5. The decrease in total free amino acids of animals acclimatized to 100% sea water and transferred to 2% sea water was measured. 6. The total free amino acid concentration is reduced to the 2% sea water level within 12 hr. after transfer. 7. Free amino acid, haemolymph sodium and total body sodium levels after transfer to 2% sea water were compared. 8. The asymmetry between the fall in haemolymph sodium concentration and the decrease in total body sodium under these conditions is thought to be due to a water shift from the haemolymph into the tissues. 9. It is suggested that the osmotic pressure of the cells falls at a slower rate than that of the haemolymph.

scholarly journals Influence of Urine Creatinine on the Relationship between the Albumin-to-Creatinine Ratio and Cardiovascular Events

2012 ◽  
Vol 7 (4) ◽  
pp. 595-603 ◽  
Author(s):  
Caitlin E. Carter ◽  
Ronald T. Gansevoort ◽  
Lieneke Scheven ◽  
Hiddo J. Lambers Heerspink ◽  
Michael G. Shlipak ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Creatinine Ratio ◽  
Urine Creatinine ◽  
The Relationship

The Effects of Sodium Loading and Deprivation on Plasma Renin and Plasma and Urinary Aldosterone in Hypertension

1972 ◽  
Vol 42 (1) ◽  
pp. 15-23 ◽  
Author(s):  
J. P. Coghlan ◽  
A. E. Doyle ◽  
G. Jerums ◽  
B. A. Scoggins
Keyword(s):  
Excretion Rate ◽  
Plasma Concentrations ◽  
Plasma Renin ◽  
Plasma Corticosterone ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Hypertensive Patients ◽  
Body Sodium ◽  
Sodium Load ◽  
Total Body

1. Measurements of urinary aldosterone excretion and of peripheral venous plasma concentrations of aldosterone, Cortisol and corticosterone have been made in hypertensive and normotensive patients after a sodium load and after dietary sodium restriction and ambulation. 2. Plasma concentrations of aldosterone, Cortisol and corticosterone did not differ significantly between the two groups of patients, but the rise in urinary aldosterone excretion was significantly greater in normotensive than in hypertensive patients after sodium restriction. 3. Division of the hypertensive patients into two groups according to the response in plasma renin on sodium restriction did not disclose any significant differences between responders and non-responders in respect of aldosterone or Cortisol, but the plasma corticosterone rose more in normotensive patients after sodium depletion than in the unresponsive hypertensive patients. 4. It is concluded that both the rise in plasma renin and in aldosterone excretion rate are blunted in hypertensive patients after sodium restriction. It is suggested that this may be due to a rise in total body sodium in hypertensive patients. 5. Differences in aldosterone excretion rate are not reflected in the values of peripheral venous concentrations, presumably because of the short-term rise in plasma aldosterone which results from ambulation.

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